When resistance to antibiotics outweighs benefits Antibiotics can only treat bacterial infections.

Rumbidzayi Zinyuke

Health Buzz

Taking antibiotics for any infection or illness seems to always make one feel confident that they will be healed.

But that is not always the case.

Recent studies have shown that there has been a noted increase in drug-resistant infections the world over, Zimbabwe included.

While antibiotics are one of the most powerful drugs for fighting life-threatening bacterial infections in people, animals, and crops, their overuse and misuse over the years have created more problems than anticipated.

For instance, how often do people visit the pharmacy and ask for an antibiotic for a flue that they feel is too severe for ordinary flue medication?

Ever had a relative who had a stash of antibiotics in the house that they “never used” and are happy to share because that drug will definitely heal you?

Some even started taking the antibiotics they got from their doctor and felt better after three or four days and decided to stop taking them.

And some of these doctors in the private sector are too happy to prescribe antibiotics whenever they see a patient.

Taking antibiotics when they are not needed is harmful

If you stop treatment before the antibiotic cycle is over, the remaining bacteria can continue to multiply. If these bacteria become resistant to the antibiotics, they can potentially do even more harm.

 It may take longer to recover from the illness, and physicians may need to prescribe more medication, which becomes expensive.

When antibiotics are needed, the benefits usually outweigh the risks of antimicrobial resistance. However, too many antibiotics are being used unnecessarily and misused, which threatens the usefulness of these important drugs.

Antimicrobial resistance happens when germs like bacteria or fungi no longer respond to the drugs designed to kill them and they continue to grow.

Zimbabwe has been recording high incidences of this.

In 2018, a study by local epidemiologists conducted after the cholera outbreak showed that there were high incidences of resistance to drugs which made it difficult to contain the outbreak using the usual antibiotics.

It was revealed that Zimbabweans were abusing antibiotics and the likely reason for this was the unregulated consumption of antibiotics and people not completing the full course when prescribed by the doctor.

In addition, the rise of counterfeit and unregistered medicines on the informal market has also fuelled the spread of AMR in the country.

In the case where infections are caused by antimicrobial-resistant germs, it becomes difficult, and sometimes impossible, to treat them.

Speaking at the second annual Global Media Forum in lead up to World Antimicrobial Awareness Week in November, World Health Organisation director, global co-ordination and partnership on AMR, Dr Haileyesus Getahun, said bacterial resistance to antibiotics directly caused 1,27 million annual deaths among humans.

Indirectly, it causes or is associated with an additional 4,95 million annual deaths.

“This huge loss of human life due to antimicrobial resistance has made it the top killer among all other diseases and conditions. The greatest burden of antimicrobial resistance is in sub-Saharan Africa and south Asia,” he said.

This makes AMR one of the most serious public health threats of the twenty-first century.

Projections show that if no action is taken immediately, the world will be facing a catastrophe by 2050 and Africa will lose about 4,1 million lives yearly to AMR attributable deaths and this will consequently result in countries losing an average 2 to 3,5 percent in Gross Domestic Product (GDP).

Zimbabwe has begun the implementation of AMR surveillance although more work is still needed to generate reliable data to assess the magnitude of AMR.

The National Development Strategy (NDS1) also seeks to address the problem and has set out plans to improve access to essential medicines, strengthening the regulation and reinforcing the rationale use of medicines.

Hopefully this will reduce the use of unregulated medicines on the black market.

Because AMR is affecting humans, animals and plants, the One Health approach has been gaining momentum as governments seek integrate and unify the approach to AMR with the aim to sustainably balance and optimise the health of people, animals, and ecosystems.

It recognises the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and interdependent.

One Health approach can effectively address the challenge of antimicrobial resistance. While Government is playing its part in addressing the issue of AMR, Zimbabweans themselves have a role to play in improving antibiotic use.

Because appropriate antibiotic use helps fight antimicrobial resistance and ensures these lifesaving drugs will be available for future generations.

According to Dr Prapti Gilada-Toshinwal, senior microbiologist and AMR advocate: “We need stronger and practical antimicrobial stewardship programme for our context and ground realities so that we can effectively promote the appropriate use of antimicrobials (including antibiotics), improve treatment outcomes, reduce antimicrobial resistance, and decrease the spread of infections caused by multidrug-resistant organisms.”

Antibiotics are lifesaving, but unnecessary exposure to them allows resistant strains to develop.

Experts say it is not necessary to treat the millions of cases of diarrhoea in humans with antimicrobials, but universal access to clean water, sanitation and hygiene could reduce cases by 60 percent.

They believe having access to clean water, sanitation, and hygiene, as well as good infection prevention and control measures, such as handwashing and vaccination reduce the likelihood of infection in the first place, so that antibiotics do not need to be used.

In the meantime, we can do much by ourselves.

For starters, they need to avoid pressuring their health care providers to give them an antibiotic prescription. 

When they do get the prescription, it is advisable to use antibiotics only as prescribed and to complete the entire treatment. Feeling better, or an improvement in symptoms, does not always mean that the infection has completely gone.

Never save antibiotics for a later illness. They may not be the correct antibiotic and they likely do not include a full treatment course.

We should also avoid taking antibiotics prescribed for other people. They will not work the same. 

This can actually delay the best treatment, make you even sicker, or cause side effects.

According to the Centres for Disease Control and Prevention, about one-third of antibiotic use in people is not needed nor appropriate.

So taking antibiotics when they are not needed will not help you, and their side effects can still cause harm.

Lastly, vaccines work.

Some of these vaccines protect against bacterial infections, such as diphtheria and whooping cough so getting them reduces the need for antibiotics.

Let us normalise living healthy lives and giving our bodies a chance to heal themselves before resorting to antibiotics.

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